Individual provider Active NPI

Sanders Schaller, MPA, PA-C

  • Medical Physician Assistant
  • Hot Springs, SD
National Provider Identifier
1740206622
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1264 Issued in SD
Practice address
500 N 5TH St
Hot Springs, SD 57747-1480
Phone
(406) 731-8888
Fax
(406) 731-8876
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1264 SD Primary

Addresses

Primary practice location

500 N 5TH St
Hot Springs, SD 57747-1480

Mailing address

500 N 5TH St
Hot Springs, SD 57747-1480
Phone (605) 891-4962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1264SDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Medicine Center LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1740206622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N 5TH ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471480",
            "telephone_number": "605-891-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 5TH ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471480",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLER",
        "first_name": "SANDERS",
        "name_prefix": "Mr.",
        "credential": "MPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": "1264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.